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Updated: Jun 13, 2026
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Guided e-MRI prostate biopsy can solve the discordance between Gleason score biopsy and radical prostatectomy
Apostolos P Labanaris1, Vahudin Zugor, Robert Smiszek
1Department of Urology, Martha Maria Medical Center, Academic Hospital of Erlangen University, Nurnberg, Germany. Labanaris@web.de
Introduction:
The aim of this study is to examine if guided prostate biopsies based on abnormalities detected by conventional and functional endorectal magnetic resonance imaging (MRI) yield a more reliable representation of the radical prostatectomy pathology and to identify probable preoperative clinical variables that stratified patients likely to harbor significant upgrading.
Patients And Methods:
From April 2004 to April 2009, a review of N=70 patients records diagnosed with prostate cancer by a 3-6 core guided transrectal ultrasound (TRUS) prostate biopsy based on abnormalities detected by conventional and functional endorectal MRI and who subsequently underwent radical prostatectomy and exhibited a significant upgrading was conducted. Additionally, a multivariate analysis with a significant upgrading as the outcome was performed including the following parameters: prostate specific antigen (PSA) level, clinical stage, prostate size and duration from biopsy to radical prostatectomy.
Results:
A significant upgrading was noted in only 8.5% of patients, with 1.4% exhibiting a significant downgrading and the rest 90.1% exhibiting an exact Gleason score match. No preoperative clinical variables that stratified patients likely to harbour significant upgrading were identified.
Conclusions:
This type of biopsy method seems to solve the discordance between the biopsy Gleason score and radical prostatectomy pathology regardless of known preoperative clinical variables that can affect it.
